[Experiences with a modified, intraocular pressure-reducing excision of the ciliary body]

The treatment of hemorrhagic secondary angle-closure glaucoma following central venous occlusion is generally very difficult. Sautter's ciliary body excision is preceded by two semicircular cyclocryocoagulations performed within 7 days of each other. If IOP remains above 30 mm Hg and the subjective complaints are unchanged, oculopression lasting 10 minutes is performed after local retrobulbar anesthesia. The lowering of pressure thus achieved is sufficient to render a Flieringa ring and paracentesis unnecessary. Several illustrations are included showing the surgical procedure. In 9 cases of hemorrhagic glaucoma following central venous occlusion, there was a further deterioration in vision 8 to 23 months postoperatively. Preoperatively, IOP was between 36 and 63 mm Hg; at late postoperative follow-ups it was between 5 and 30 mm Hg. Complications worth mentioning included three slight losses of vitreous, bleeding into the anterior chamber in four cases, and one loss of the anterior chamber with caput medusae of the iris and secondary opacification of the lens. In 2 cases of aphakic secondary angle-closure glaucoma there was no deterioration in vision and a lowering of pressure to under 30 mm Hg, in spite of 3 preceding intraocular operations. The authors regard the slightly modified ciliary body excision as a possible way of preserving the bulb.